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SAFELY EMBRACING CULTURE: THE ADEQUACY OF THE CULTURAL SAFETY PARADIGM IN CANADIAN AND AMERICAN INDIGENOUS HEALTHCARE —t1o> ERIC SMITH! ABSTRACT The Canadian and American healthcare systems have long histories of providing inequitable and ineffective care for Indigenous persons. This ineffectiveness is largely attributable to the confluence of socio-political inequities and a lack of understanding of Indigenous culture amongst healthcare providers. In an attempt to rectify this lack of understanding, a group of Maori nurses developed the cultural safety paradigm. Building off of the failures of its predecessors, this paradigm encourages healthcare providers to understand health holistically and socio-historically, in and through systems of value (i.e., cultures). The conceptual promise of the paradigm has led to its adoption into Canadian and American healthcare, but has been appropriated in a way that perpetuates the very problems it aims to rectify. Although cultural safety is a step towards more equitable healthcare, a new precedent of cultural understanding is needed for truly effective care for Indigenous persons. INTRODUCTION The Canadian and American healthcare systems have long histories of providing inequitable and ineffective care for Indigenous persons.’ Although Canadian healthcare has long been touted for its “universal care” and American healthcare has similarly been recognized for its innovativeness, the umbrellas of universality and innovation have rarely covered the Indigenous groups of North America. Since first contact, both Canadian and American settlers have justified this lack of coverage using the language of the “Indian problem”, an erroneous ! University of Alberta. ? Piotr Wilk - Alana Maltby - Joel Phillips, Unmet Healthcare Needs among Indigenous Peoples in Canada: Findings from the 2006 and 2012 Aboriginal Peoples Surveys, Journal of Public Health, Vol. 26, No. 4 (2018), 481-483. Based on indigenous identity, gender, age, geographic region and urban/rural area. Additionally, frequency distributions were produced for reasons for UHN and types of care needed. Standard errors and confidence intervals were calculated and took into account bootstrap weights. Results: In 2006, 11.65% (CI: 11.04, 12.26) + 245 +
